Bleeding After Sex: Causes & Treatment

Bleeding after sex is an unwelcome occurrence and a source of stress and frustration for people who experience it. 

When that happens, people automatically generate tons of scenarios in their heads. 

But what is actually going on? Find out below. 

In this post, you’ll learn more about bleeding after sex, why it happens, and what to do about it. 

What is bleeding after sex?

The term postcoital bleeding is used to describe cases of genital bleeding after sexual intercourse. In the medical community, this term usually applies to women. But women aren’t the only ones who can experience bleeding after sex. 

While it’s not a standalone disease or condition, bleeding after sexual intercourse can be a symptom of some health problems. You shouldn’t ignore it, especially if bleeding is persistent and happens quite frequently. 

Accompanying symptoms

The accompanying symptoms of bleeding after sex depend on the specific cause. Some of these symptoms include:

• Unusual vaginal discharge
• Chronic discharge
• Vaginal itching/burning
• Nausea and/or vomiting
• Lower back pain
• Severe abdominal pain
• Painful intercourse
• Fever
• Redness and tenderness
• Swelling in the genital area

What causes vaginal bleeding after sex?

Numbers show that the prevalence of postcoital bleeding is between 0.7% and 9.0% in menstruating women. Women are more likely than men to bleed after sexual intercourse due to their anatomy. The most common causes of vaginal bleeding after sex are discussed below.

Menstruation

Before you start panicking about bleeding after sex, consider whether it’s due to menstruation. If you have sexual intercourse right before or after your period, it could explain the bleeding. 

Sometimes menstruation isn’t regular and starts sooner or later than expected. Do your best to keep track of your menstrual cycle and leave some room for the possibility that post-coital bleeding is actually your period. 

Vaginal dryness

Vaginal atrophy (atrophic vaginitis), or vaginal dryness, is the absence of normal moisture in the vagina. The most common cause of vaginal dryness is menopause, but it can also happen in the years leading up to menopause. Other causes of vaginal dryness can be hormonal too, but also non-hormonal.

Hormonal causes of vaginal dryness are reduced estrogen levels due to childbirth, breastfeeding, cancer treatment, or anti-estrogen drugs. Non-hormonal causes are cold and allergy medications, some antidepressants, Sjogren syndrome, and others.

Vaginal dryness causes irritation, burn, and pain during sexual intercourse. It is also the most common cause of bleeding after sex in women. The dryness of mucus-producing tissues makes the vagina vulnerable to damage due to friction, which can cause tiny tears and bleeding. 

Cervicitis

Cervicitis is an inflammation of the cervix, the end of the uterus. Potential causes of cervicitis include: 

• Sexually transmitted infections (STIs), including gonorrhea, Chlamydia, trichomoniasis, and genital herpes
• Bacterial overgrowth
• Allergic reactions to condoms, feminine hygiene products, etc.

Sometimes cervicitis is asymptomatic, but some women do experience symptoms. When they appear, symptoms usually include unusual vaginal discharge, painful intercourse, painful urination, bleeding between periods, and vaginal bleeding after sex.

Cervical ectropion

Cervical ectropion occurs when glandular cells, i.e., the cells from inside of the cervical canal, grow on the outside of the cervix. 

Also known as cervical erosion or cervical ectopy, it is a benign condition that frequently affects women of reproductive age. Cervical ectropion results from increased exposure of the cervical epithelium to estrogen.

Common symptoms of cervical ectropion include pain and bleeding after sex, light bleeding between periods, after exercise, having a lot of discharge without an infection, and others. 

Cervical polyps or fibroids

Cervical polyps are growths on the cervical canal. These fingerlike growths are reddish, purplish, or grayish. Chronic inflammation and changes in hormone levels are the most common causes of cervical polyps.

The most common symptoms of cervical polyps are very heavy menstrual periods, leucorrhea (white or yellow mucus), abnormal bleeding after menopause or between periods, and vaginal bleeding after intercourse. 

Cervical cancer

Cervical cancer is cancer of the cervix. According to the CDC, each year, around 13,000 new cases of cervical cancer are diagnosed, whereas 4000 women die of this cancer. It is most frequently diagnosed in women between the ages of 35 and 44, but the average age of diagnosis is 50, according to the American Cancer Society.

The main cause of cervical cancer is long-lasting infections with certain types of human papillomavirus (HPV), a common virus passed through sexual intercourse.

Vaginal bleeding after sexual intercourse is among the most common symptoms of cervical cancer. Other symptoms include bleeding between periods, longer and heavier menstrual bleeding than usual, pain during intercourse, pelvic pain, vaginal bleeding after menopause, and a change in vaginal discharge.

Uterine prolapse

Uterine prolapse results from stretching and weakening of pelvic floor muscles and ligaments until they are no longer able to support the uterus. 

When that happens, the uterus slips down or protrudes into the vagina. It usually affects postmenopausal women, particularly those with one or more vaginal deliveries.

Seeing or feeling tissue bulge out of the vagina is the most common symptom of uterine prolapse. Other symptoms include heaviness, urinary incontinence, difficulty having a bowel movement, pressure or discomfort in the pelvis or lower back, and others. In severe cases, uterine prolapse can cause bleeding after sexual intercourse. 

Vaginal tearing

In many cases, vaginal bleeding after sexual intercourse isn’t a consequence of some infection or other problem. Sometimes vigorous or rough sexual intercourse is the culprit. 

Vigorous sex can cause small cuts and scrapes to the tissues in the vagina. This can lead to bleeding. The problem is more likely to occur with vaginal dryness, but other women can also experience it. Vigorous sex, in this case, also includes the use of sex toys which may also contribute to tearing and bleeding.

Endometriosis 

Endometriosis is a condition wherein a tissue similar to the endometrium (lining of the womb) grows in other places, such as fallopian tubes and ovaries. 

Common causes of endometriosis are retrograde menstruation, the transformation of peritoneal cells, immune system disorders, and others.

Symptoms of endometriosis are dysmenorrhea (painful periods), painful intercourse, pain with urination and bowel movements, intermenstrual bleeding, and infertility, among others. 

One of the most common symptoms of endometriosis is bleeding after sexual intercourse. It happens because penetration causes irritation and tenderness of uterine tissue.

To sum up, vaginal bleeding after sex results from several problems, including injuries, vaginal dryness, infections, conditions affecting the cervix, and cancer. 

What causes penile bleeding after sex?

Penile bleeding after sex isn’t as common as vaginal postcoital bleeding. The most common causes of penile bleeding after intercourse are discussed below.

Injury

Like in women, injuries can cause bleeding after sexual intercourse in men as well. Both minor and major injuries can lead to this outcome. In most cases, these injuries are due to rough or vigorous sex.

STIs

Sexually transmitted infections such as gonorrhea, Chlamydia, and genital herpes can lead to bleeding after intercourse. 

These infections spread through vaginal, anal, or oral sex. Their most common symptoms are painful or burning urination and discharge from the penis. STIs are the biggest cause of bleeding after sex in men.

Hematospermia

Hematospermia, or hemospermia, is the presence of blood in ejaculation. Urogenital infection is the most common cause of hematospermia, particularly in males younger than 40. Besides seeing blood in semen, i.e., after sex, men may also experience other symptoms, such as painful ejaculation.

Prostatitis 

Prostatitis is inflammation of the prostate gland. Causes of prostatitis depend on the type of the condition. Some types of prostatitis are caused by bacteria, whereas others have no known cause.

Common symptoms of prostatitis include dysuria (painful urination), nocturia (urination at night), painful ejaculation, and others. Prostatitis can also cause bleeding after sex or bloody ejaculation.

Benign prostatic hyperplasia (BPH)

Benign prostatic hyperplasia, enlarged prostate, is the benign growth of this important gland. The condition causes lower urinary tract symptoms that range from mild to severe. Prostate enlargement affects men in different ways, and one of them is bleeding after sex. 

While this isn’t a common symptom of BPH, sometimes blood in semen happens among men with BPH. 

Prostate cancer

About one in eight men will be diagnosed with prostate cancer at one point in his life. Prostate cancer is the second leading cause of cancer death in American men.

Men with prostate cancer experience difficulties are starting urination, weak or interrupted urine flow, pain or burning when urinating, and blood in urine and semen, as well as other symptoms. So, one potential cause of penile bleeding after sex is prostate cancer. 

What causes anal bleeding after sex?

Anal bleeding after sex occurs mainly due to anal sex. Bleeding after anal sex is quite common. 

During anal sex, tears can form on the wall of the anus. This results in anal fissures. They can cause bleeding and discomfort. Also, sometimes STIs can cause anal bleeding after sex. 

Risk factors for bleeding after sex

Everyone can bleed after sexual intercourse. Some people are at a higher risk than others, though. Common risk factors for bleeding after sex include:

• Being a woman
• Cervical or uterine cancer
• Not being sexually aroused before intercourse
• Perimenopause, menopause, and being postmenopausal
• Douching frequently
• Recently having given birth and currently breastfeeding
• Tendency to engage in extreme sexual activity, i.e., rough sex
• Recent surgical procedures in the genital area 
• Immune conditions 
• Taking immunosuppressant medications 
• Lack of sexual experience
• High blood pressure
• Diabetes 

Is bleeding after sex serious?

Bleeding after sex isn’t always serious, but it can be. Since you can’t know immediately whether postcoital bleeding is a serious problem or not, you should see a doctor. Bleeding after sex could be serious if it keeps happening and other symptoms, such as severe pain, accompany it at the same time. 

When to see a doctor

A small amount of bleeding occasionally isn’t a source of concern, and you don’t need to see a doctor. However, if the problem persists, you should schedule an appointment to see your healthcare provider. 

This is particularly important if you also experience accompanying symptoms such as fever, discharge, and pain. Menopausal women, however, should see a doctor immediately. 

Diagnosis

National or international guidelines or diagnostic criteria regarding postcoital bleeding don’t exist. The reason for that is simple; bleeding after sex isn’t a specific health problem or a disease. 

When you see a doctor, their main goal is to establish the cause and diagnose the problem. To make that happen, they will ask questions about symptoms and medical history and perform a physical exam. 

The doctor may also recommend various tests, including blood tests, pregnancy tests, culture tests for infection, colposcopy, a biopsy of abnormal growth or mass, and others, if necessary. 

Based on the test results and information gathered during a physical exam, the doctor will be able to diagnose the cause of the bleeding after sex. 

Can bleeding after sex go away on its own?

In some cases, bleeding after sex goes away on its own. These are usually occasional cases of bleeding that aren’t accompanied by serious symptoms. 

When postcoital bleeding is a consequence of a more serious problem, such as the causes described above, it will not go away on its own. The only way to eliminate the problem is to treat the underlying cause. 

Treatment

The treatment for bleeding after sex depends on the cause. Sometimes the cause is unknown, and the specific treatment is lacking. The doctor recommends the most suitable treatment option based on the severity of the bleeding and other symptoms the patient experiences. 

Potential treatments include:

• Antibiotics for infections caused by bacteria such as syphilis, gonorrhea, and Chlamydia
• Therapy or surgery for cancer
• Medications for viral infections
• Removal of polyps
• Management of an underlying problem such as enlarged prostate, prostatitis, and others
• Cryotherapy, electrocautery, and surgical removal for cervical ectropion
• Low-dose vaginal estrogen therapy for vaginal dryness.

Preventing bleeding after sex

Sometimes it’s impossible to prevent minor postcoital bleeding. The good news is that you can reduce the risk of this uncomfortable problem for yourself and your sexual partner. 

You may want to:

• Stay hydrated
• Wait to get aroused before engaging in sexual intercourse
• Use water- and silicone-based lubricants during foreplay and intercourse
• Avoid scented and flavored products for the genital area
• Use vaginal moisturizer 
• Avoid engaging in risky sex acts
• Use condoms
• Be proactive about the management of infections in the genital area; see your doctor 
• Use supplements such as Omega-3 fatty acids, vitamin E, and black cohosh to reduce vaginal dryness (for women)
• Use supplements such as l-citrulline, l-arginine, vitamin D, nettle root, saw palmetto, and other products that support prostate function and male sexual health (for men).

Conclusion

Bleeding after sex is a common occurrence. It is more common in women, but men can experience this problem too. 

Various causes and factors can contribute to postcoital bleeding. Sometimes bleeding goes away on its own, but in other cases, it doesn’t. If the problem persists and appears with other uncomfortable symptoms, such as pain, make sure to see your doctor.

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